Few children with hepatitis C virus (HCV) infection -- especially those
who are infected perinatally -- achieve viraemia clearance in the medium-term,
suggests a multicentre European study.

Dr. Paloma Jara from the Hospital Infantil La Paz, in Madrid, Spain,
and colleagues retrospectively examined the characteristics and evolution
of HCV infection among HCV RNA seropositive children seen at seven centres
in Spain, Italy and Belgium between 1980 and 1998.

The researchers followed 200 white children who were positive for a mean
of 6.2 years. At baseline, 87% of all children enrolled were asymptomatic
and 48% had alanine aminotransferase (ALT) levels that were at least 2
times the upper limit of normal.

Results showed that 6% of children achieved sustained viremia clearance
and normalisation of the ALT level at the end of follow-up. In 92 revised
liver biopsy specimen analyses, the mean fibrosis score was 1.5 for children
younger than 15 and 2.3 for those who were 15 or older (p<0.01).

The authors conclude that, although paediatric HCV infection is usually
mild, few patients, and especially those infected perinatally, clear viremia
in the medium-term.

Conversely, the higher rates of fibrosis observed in older patients suggest
the possibility of an insidious progression of HCV-associated liver disease,
they add.